Drug Reference

How Does My Doctor Know I Have Stomach Cancer?

If you have an upper GI series or a barium swallow, your doctor will use X-rays to look at your stomach.

If you’re having symptoms that are like those of stomach cancer, your doctor will want to know why. Your doctor is likely to ask you questions about these things:

Medical history

Family history of cancer

Lifestyle habits, such as what you eat and whether or not you smoke

Any previous stomach surgeries or stomach ulcers

Any symptoms or discomfort

In addition to asking you these questions, the doctor will also do a physical exam, blood tests, and one or more of the following tests. The results of these tests may be enough to rule out cancer. Or you may need more tests to confirm a diagnosis.

Fecal occult blood test (FOBT)

This test checks for hidden blood in your stool. The doctor may place a small amount of your stool on a plastic slide or a special type of paper, or you may do this test at home. Stomach cancer can sometimes cause small amounts of bleeding that is hard to see. But so can certain noncancerous conditions. Even if the test shows blood in your stool, you will likely need other tests to confirm whether or not it is due to cancer.

Upper endoscopy

This test is also called an esophagogastroduodenoscopy (EGD). This procedure helps find most stomach cancers. During this test, a doctor looks inside your stomach with a thin, lighted tube called an endoscope. The doctor guides it through your throat and down into your stomach. You are sedated during this test. An upper endoscopy also checks your esophagus and part of your duodenum, which is the first section of your small intestine. If the doctor sees tissue that is abnormal, he or she takes a small sample to be checked for cancer cells. This sample is called a biopsy. A pathologist looks at the sample under a microscope. In addition to checking for stomach cancer, this biopsy can also tell whether H. pylori bacteria infection, noncancerous disease, or another type of cancer called a lymphoma is present. Your doctor may do an upper endoscopy along with an endoscopic ultrasound (EUS) exam. The EUS uses sound waves to make a better picture of your stomach, nearby tissues, and lymph nodes.

Upper GI series

This is also called a barium swallow. During this test, even small abnormalities in the stomach can be seen. This test is less common than it once was. For this exam, you’ll drink a thick, chalky fluid with barium in it. This fluid lines the stomach, making it easier to see on an X-ray. To see very early cancers, the doctor may use a double contrast technique. For this, a small tube is placed in the stomach after drinking the barium. Air is then pumped into your stomach to make the barium coating thinner.

Laparoscopic surgery

During this procedure, the surgeon makes a small incision in the skin and inserts an instrument to examine the inside of the abdomen. If any suspicious lesion is found, it can be removed and looked at under the microscope. This is called a laparoscopic biopsy.

To confirm a diagnosis, your doctor will need to remove tissue from your stomach and have it examined under a microscope. This is called a biopsy.